摘要
目的 观察脱花煎加味联合芬吗通治疗不全流产患者的临床疗效及对其激素水平和子宫复旧的影响。方法 选取2023年7月—2025年2月河北省第七人民医院收治的不全流产患者120例,按照随机数字表法分为对照组和治疗组,每组各60例。对照组给予芬吗通治疗,治疗组在对照组治疗的基础上联合脱花煎加味治疗,两组患者均连续治疗28 d。观察比较两组患者临床疗效、子宫复旧情况[阴道出血时间、月经复潮时间、恶露持续时间、血β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-hCG)转阴时间]、不良反应发生情况,治疗前后中医证候积分、激素水平[雌二醇(Estradiol,E_(2))、β-hCG、黄体生成素(Luteinizing hormone,LH)、卵泡刺激素(Follicle-stimulating hormone,FSH)]和子宫超声参数[搏动指数(Pulse index,PI)、阻力指数(Resistance index,RI)、子宫内膜厚度(Endometrial thickness,EM)、宫腔内组织残留面积]。结果 治疗后治疗组临床总有效率93.33%(56/60)明显高于对照组80.00%(48/60),差异有统计学意义(P<0.05)。治疗7 d、14 d、28 d后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组中医证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后治疗组阴道出血、月经复潮、恶露持续、血β-hCG转阴时间均明显短于对照组,差异有统计学意义(P<0.05)。治疗7 d、14 d、28 d后,两组患者E_(2)、FSH水平均较治疗前升高,β-hCG、LH水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组E_(2)、FSH水平明显高于对照组,β-hCG、LH水平明显低于对照组,差异有统计学意义(P<0.05)。治疗7 d、14 d、28 d后两组患者PI、RI、宫腔内组织残留面积均较治疗前降低,EM均较治疗前升高,差异有统计学意义(P<0.05);且治疗组PI、RI、宫腔内组织残留面积明显低于对照组,EM明显高于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 脱花煎加味联合芬吗通可明显缓解不全流产患者中医临床症状,调节激素水平及子宫超声参数,促进子宫复旧,且未增加不良反应。
Objective To observe the clinical efficacy of modified Tuohua Decoction combined with Femoston for incomplete abortion and the combined treatment's effect on patients'hormone levels and uterine involution.Methods A total of 120 patients with incomplete abortion admitted to the Seventh People's Hospital of Hebei Province from July,2023 to February,2025 were selected and divided into a control group and a treatment group by the random number table method,with 60 cases in each group.Both groups received Femoston,while the treatment group additionally received Tuohua Decoction.After continuous treatment for 28 days,clinical efficacy,uterine involution[vaginal bleeding time,menstrual regain time,lochia duration,and bloodβ-human chorionic gonadotropin(β-HCG)negative time],and adverse reactions were compared between the two groups,as well as aspects below before and after treatment:traditional Chinese medicine(TCM)syndrome scores,hormone[estradiol(E_(2)),β-hCG,luteinizing hormone(LH),follicle-stimulating hormone(FSH)]levels,and uterine ultrasound parameters[pulse index(PI),resistance index(RI),and endometrial thickness(EM)].Results After treatment,the total clinical effective rate was 93.33%(56/60)in the treatment group,which was significantly higher than 80.00%(48/60)in the control group(P<0.05).After 7,14,and 28 days of treatment,TCM syndrome scores were decreased in both groups(P<0.05),with these scores being significantly lower in the treatment group(P<0.05).Specifically,the treatment group exhibited shorter vaginal bleeding,menstrual regain,and bloodβ-hCG negative time,as well as lochia duration(P<0.05).E_(2) and FSH levels were increased,whileβ-hCG and LH were decreased in both groups(P<0.05),with these changes being more significant in the treatment group(P<0.05).PI,RI,and intrauterine tissue residue area were decreased,while EM was increased in both groups(P<0.05),with these changes being more significant in the treatment group(P<0.05).During treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion For patients with incomplete abortion,modified Tuohua Decoction combined with Femoston can significantly relieve the clinical TCM symptoms while regulating hormone levels and uterine ultrasound parameters,promoting uterine involution without increasing adverse reactions.
作者
刘春丽
高晰
李红月
LIU Chun-li;GAO Xi;LI Hong-yue(The Seventh People's Hospital of Hebei Province/Second Affiliated Hospital of Hebei University of Chinese Medicine,Baoding Hebei 073000)
出处
《世界中西医结合杂志》
2025年第11期2222-2227,共6页
World Journal of Integrated Traditional and Western Medicine
基金
河北省2024年度中医药类科学研究课题计划项目(2024302)。
关键词
脱花煎加味
芬吗通
不全流产
激素水平
子宫复旧
Modified Tuohua Decoction
Femoston
Incomplete Abortion
Hormone Level
Uterine Involution
